Health Facility Design Checklist Monograph · Health Facility Design Information Checklist 1...
Transcript of Health Facility Design Checklist Monograph · Health Facility Design Information Checklist 1...
Health Facility DesignInformation Checklist
HKS Inc.Joseph G. Sprague, FAIA, FACHA, FHFITodd Gritch, FAIA, FACHA, CBORon Gover, AIA, FACHAJohn Bienko, AIATina Duncan, AIA
Mazzetti + GBAWalter Vernon, PE
Smith Seckman ReidClay Seckman, PE, HFDP
TLC Engineering for Architecture Kim E. Shinn, PE, LEED Fellow
ASHE Monograph
HKS Inc.Dallas, TXJoseph G. Sprague, FAIA, FACHA, FHFITodd Gritch, FAIA, FACHA, CBORon Gover, AIA, FACHAJohn Bienko, AIATina Duncan, AIA
Mazzetti + GBASan Francisco, CAWalter Vernon, PEContributing Authors:James Ferris, PEJim Peterkin, PETaw North, PE
Smith Seckman ReidNashville,TNClay Seckman, PE, HFDPContributing Authors:Rick Wood, PETony Johnson, PE
TLC Engineering for ArchitectureBrentwood, TN Kim E. Shinn, PE, LEED FellowContributing Authors:Norm Brown, PE, LEED APArash Guity, PE, CEM, LEED APJill ConnellBrian Hageman, LEED APEric Sweet, PE, CxA, LEED AP
ASHE Monograph
Health Facility DesignInformation Checklist
ASHE Disclaimer
This document is provided by ASHE as a service to its members. The information provided maynot apply to a reader’s specific situation and is not a substitute for application of the reader’s ownindependent judgment or the advice of a competent professional. Neither ASHE nor any authormakes any guaranty or warranty as to the accuracy or completeness of any information containedin this document. ASHE and the authors disclaim liability for personal injury, property damage,or other damages of any kind, whether special, indirect, consequential, or compensatory, that mayresult directly or indirectly from use of or reliance on this document.
© 2017 ASHE
The American Society for Healthcare Engineering (ASHE)of the American Hospital Association155 North Wacker Drive, Suite 400
Chicago, IL 60606312-422-3800
ASHE members can download this monograph from the ASHE website under theResources tab. Paper copies can be purchased from www.ashestore.com.ASHE catalog #: 055575
vHealth Facility Design Information Checklist
Contents
Health Facility Design ChecklistIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Part 1: Project InformationProject Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Project Directory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Part 2: Facility DevelopmentSite Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Planning and Zoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Fire Prevention, Detection, and Protection Systems . . . . . . . . . . . . . . . . . . . . 17
Part 3: Building SystemsHeating, Ventilation, and Air Conditioning Systems . . . . . . . . . . . . . . . . . . . . 23
Plumbing Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Natural Gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Domestic and Fire Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Plumbing Fixtures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Sanitary Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Storm Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Bulk Medical Gases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Part 4: AppendixSustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Additional Information and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
vi ASHE Monograph
1Health Facility Design Information Checklist
Introduction
In July of 2016 the Centers for Medicare & Medicaid services (CMS) adopted the 2012 edition of NFPA 101: Life Safety Code®, replacing the 2000 edition. As the CMS is the primary federal agency setting health care standards, this adoption will significantly change the health care regulatory environment. This checklist was originally conceived and published in 2008. In the intervening years virtually every regulatory standard applicable to health care has been updated and revised, thus it is appropriate to update and revise the Health Facilities Design Information Checklist monograph.
Health care is one of the most intensely regulated fields of design. The maintenance and operations of health care facilities are subject to numerous federal, state, local, and accreditation agency regulations. This checklist provides a useful tool to gather data and answer fundamental questions associated with the architectural, mechanical, electrical, plumbing, technology, and fire protection requirements of new construction and major renovation projects. It contains a series of questions that prompt attention to critical issues that affect the issuance of a certificate of occupancy including site considerations, planning and zoning requirements, state and local codes, fire safety ordinances, natural gas supplies, domestic and fire water requirements, sanitary sewer facilities, and electrical power. This document should be coordinated with the owner’s overall project requirements in terms of project scope, purpose, and objectives.
One of the many uses of this checklist is to help lessen the possibility of overlooking essential zoning and code requirements that could impede the progress of a construction project or delay the review of plans and specifications by city, state, or local inspectors. The checklist also provides space for recording names of key individuals who will serve as technical resources throughout the project, including the state architect, fire marshal, health officials, inspectors, zoning authorities, and utility personnel.
This checklist contains items that may vary from one jurisdiction to another in application, interpretation, or basic requirement. While it would be impossible to provide a complete listing of all codes for all projects, the checklist should
2 ASHE Monograph
provide, in combination with other code documents, a comprehensive resource and reference for most construction projects and maintenance of most facilities. This document can serve as a resource in establishing clear lines of communication with the authorities having jurisdiction (AHJs). In some sense, owners could use this document to validate to what degree their project teams have done the necessary due diligence in code research and general project requirements to meet the project’s design and scope provisions for a successful outcome.
When the checklist is used appropriately at the beginning of the project, most misunderstandings and delays can be avoided by better planning and communication. This document and its appendix will provide a useful tool to the health care community to increase their understanding of the regulatory environment.
3Health Facility Design Information Checklist
Part 1: Project Information
Project Summary
Date of Project Permit: _______________________________________________________
Project Name: _______________________________________________________________
Project Location: _____________________________________________________________
Client Representative: ________________________________________________________
Client Representative Phone Number: ___________________________________________
Report Prepared by: __________________________________________________________
Applicable Codes
Building Code: ______________________________________________________________
Plumbing Code: _____________________________________________________________
Mechanical Code: ____________________________________________________________
Energy Code: ________________________________________________________________
Accessibility Code(s): _________________________________________________________
Electrical Code: ______________________________________________________________
Fire Code: __________________________________________________________________
State or Local Amendments: ___________________________________________________
Life Safety Code: _____________________________________________________________
Sign Code: __________________________________________________________________
Department of Health Licensing:________________________________________________
Seismic Code: _______________________________________________________________
Building Insurance Standards: __________________________________________________
Other: _____________________________________________________________________
4 ASHE Monograph
Building Planning
Type of Construction: _________________________________________________________
New construction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Existing construction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If existing, describe scope: _________________________________________________
_______________________________________________________________________
Occupancy Group(s): _________________________________________________________
Mixed occupancy: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Separated: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Seismic Category: ____________________________________________________________
Vibration Limitations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If yes, explain: ___________________________________________________________
Fully Sprinklered? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
High Rise? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
General Building Limitations
ITEM ALLOWED/REQUIRED ACTUAL/PROVIDED
Height of building
Number of stories
Max . single floor area
Total area of building
Penthouse and roof structure
Parking spaces STD: TTL: STD: TTL:
ACC: ACC:
Number of Stories (below grade): _______________________________________________
Future Vertical Expansion: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If yes, number of additional stories:______________________________________________
Number of Beds: Existing _____________ New ______________ Total _________________
Additional Notes: ____________________________________________________________
___________________________________________________________________________
5Health Facility Design Information Checklist
Project Directory
Owner
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Architect
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Mechanical and Plumbing Engineer
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Electrical Engineer
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
6 ASHE Monograph
Information Technology
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Structural Engineer
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Civil Engineer
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Geotechnical Engineer
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
7Health Facility Design Information Checklist
Commissioning Agency
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Building Insurance
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Contractor
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Other
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
8 ASHE Monograph
Other
Name of Company/Firm: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Authorities Having Jurisdiction
Accrediting Organization: ____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
State Architect: _____________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
State Health: _______________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
9Health Facility Design Information Checklist
State Plumbing: ____________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
State Fire Marshal: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Local Fire Chief/Marshal: _____________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Local Fire Inspector: _________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
10 ASHE Monograph
Local Building Official: _______________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Building Inspector: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Building Plan Reviewer: ______________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Planning and Zoning Official: _________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
11Health Facility Design Information Checklist
Electrical Inspector: _________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Mechanical Inspector: _______________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Plumbing Inspector: ________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
Other
Title: ______________________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: __________________________________________________________________
Phone: _________________________________________________________________
12 ASHE Monograph
Utilities
Gas Company
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
Water Company
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
Sanitary Sewer
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
13Health Facility Design Information Checklist
Storm Sewer
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
Power Company
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
Telecommunications/Internet Provider
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
Other
Name of Company: __________________________________________________________
Phone: ____________________________________________________________________
Street Address: ______________________________________________________________
City, State, Zip Code: __________________________________________________________
Contact Name/Title/Position: _______________________________________________
Email: _________________________________________________________________
Phone: _________________________________________________________________
14 ASHE Monograph
PART 2: FACILITY DEVELOPMENT
Site Considerations
1 . List the general soil strata depths in this area and provide a general description of each:
_______________________________________________________________________
_______________________________________________________________________
2 . Is there any expansive soil at this site or area? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
3 . What is the water level at this site? __________________________________________
4 . Is there any evidence of landfill at this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
5 . What is the slope of the land across the site and building footprint? _______________
_______________________________________________________________________
6 . Is there any significant vegetation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what type? ______________________________________________________
7 . Are any easements or right-of-ways associated with this site? . . . . . . . . . . . . Yes No
8 . Are there any mineral wellheads on this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . In operation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
9 . What is the status of the mineral and water rights on this property? _______________
_______________________________________________________________________
10 . In high seismic areas (IBC categories D, E, F), are there site hazards
such as liquefaction, slope instability, or surface rupture? . . . . . . . . . . . . . . . . . Yes No
11 . Is the site located in an environmentally sensitive area
(wetlands, steep slopes, etc .)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what type? ______________________________________________________
12 . What is the site class per latest approved edition of the International Building Code?
_______________________________________________________________________
13 . Is liquefaction considered a possibility for the soil types at this site? . . . . . . Yes No
14 . What is the general history of seismic activity at this site? ________________________
_______________________________________________________________________
_______________________________________________________________________
15 . What type of foundation elements are most common for buildings in the general area
of this site? _____________________________________________________________
_______________________________________________________________________
15Health Facility Design Information Checklist
16 . Which soil strata is most suitable for support of major building column loads? _______
_______________________________________________________________________
_______________________________________________________________________
17 . Do the soils in the general area of this site exhibit properties that lead
to corrosion of buried ferrous elements, deterioration of below-grade
concrete, or other concerns? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what concerns? __________________________________________________
18 . Are wetland mitigation offsets required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
19 . Would this site be considered “brownfield land”? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
20 . Are there any known below-grade contaminants at this site? . . . . . . . . . . . . Yes No
21 . Is there a Phase I Environmental Report for the site? . . . . . . . . . . . . . . . . . . . . . . Yes No
22 . Is any part of the site located in a flood plain? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, is there a 100-year floor map? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
23 . Has the run-off report been completed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, when was it completed? ___________________________________________
24 . Is the property on a wellfield or other environmentally sensitive area? . . . . Yes No
a . If yes, what type of sensitive area? ________________________________________
25 . What level of FAA-approved lighting is needed? _______________________________
16 ASHE Monograph
Planning and Zoning
1 . Is this site platted? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is a survey available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Is the site platted within an incorporated city? . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Is the site platted within an extraterritorial jurisdiction? . . . . . . . . . . . . . . Yes No
2 . How is the project site presently zoned? ______________________________________
a . How does it fit within the city master plan? ________________________________
3 . What is the zoning of the adjacent property? __________________________________
a . Are there any residential proximity issues? ________________________________
___________________________________________________________________
4 . Is a special use permit/re-zoning required for this proposed
building site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
5 . What are the setback requirements? ________________________________________
_______________________________________________________________________
6 . What is the height restriction? ______________________________________________
a . How is it determined? _________________________________________________
b . Are there any height restrictions or setbacks relative to proximity?_____________
___________________________________________________________________
7 . What is the floor-to-area ratio at this site? ____________________________________
8 . Is there a floodplain or flow located on this property? . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, is it platted? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
9 . Are there any wetlands on or near the property? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
10 . Are there any deed restrictions or restrictive covenants on this site? . . . . . . Yes No
11 . Are there any approach departure paths from nearby airports or helistops
applicable to this site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
12 . Are there any noise or odor concerns at this site? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
13 . Are there any historical environmental sensitivities? . . . . . . . . . . . . . . . . . . . . . . Yes No
14 . Are there any cemeteries nearby? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
15 . Is there a local design review process? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
16 . Are there any parking restrictions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, explain ________________________________________________________
17 . Are there any loading restrictions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, explain ________________________________________________________
18 . Are there any know hazards on or near the site; i .e ., railroad lines? . . . . . . . . Yes No
a . If yes, explain ________________________________________________________
17Health Facility Design Information Checklist
Fire Prevention, Detection, and Protection Systems
Fire Resistance Rating Requirements
BUILDING ELEMENT RATING REQUIRED/HOUR
UL LISTING
Primary structural frame
Bearing walls
Nonbearing walls and partitions — Exterior
Nonbearing walls and partitions — Interior
Floor and associated secondary members
Roof and associated secondary members
1 . Is a fire lane required around building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
2 . How are the distances measured to the building from the fire lane? _______________
_______________________________________________________________________
3 . What is the fire truck access (width, radii, hammer head, etc .)? ____________________
_______________________________________________________________________
4 . Can the automatic fire alarm be connected to the local fire department? . . . Yes No
5 . Is a fire command center required in the building? . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is direct access to the outside required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
6 . What type of fire alarm supervision is required/provided?
Remote station service
Proprietary station service
Central station service
Public fire alarm reporting system
7 . Where are fire alarm annunciators required for fire department use? _______________
_______________________________________________________________________
a . What type is required? LCD Graphic
8 . What are the requirements for elevator recall? _________________________________
_______________________________________________________________________
_______________________________________________________________________
18 ASHE Monograph
9 . Is an elevator lobby required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, will an alternate means be provided by:
Hoistway smoke and draft control door assembly? . . . . . . . . . . . . . . . . . . . Yes No
Pressurization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
10 . What color exit lights are required? Red Green
11 . Are fire alarm initiation circuits required to be class “A”? . . . . . . . . . . . . . . . . . . Yes No
12 . In what areas of the building is smoke detection required? _______________________
_______________________________________________________________________
_______________________________________________________________________
13 . Smoke detectors required in:
a . Corridors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Patient rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Sleeping rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Storage rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e . Mechanical rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f . Areas open to corridors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g . IT closets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
h . Elevator lobbies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i . Elevator machine rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
j . At fire/smoke doors magnetically held open . . . . . . . . . .
k . At doors into pressurized stair enclosure . . . . . . . . . . . . .
l . At each fire alarm control panel . . . . . . . . . . . . . . . . . . . . . .
m . Other: ______________________________________________________________
14 . Type of fire extinguishers required:
a . Corridors . . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . .Pres . water . . . . Other
b . Electrical rooms . . . . . . . . . . . . . . . . . . . .ABC . . . . . .CO2 . . . . . . . . . . . Other
c . Storage rooms . . . . . . . . . . . . . . . . . . . . .ABC . . . . . .Pres . water . . . . Other
d . Mechanical rooms . . . . . . . . . . . . . . . . . .ABC . . . . . .CO2 . . . . . . . . . . . Other
e . Kitchen hoods . . . . . . . . . . . . . . . . . . . . . .CO2 . . . . . . .H2O . . . . . . . . . . . Other
f . Operating rooms . . . . . . . . . . . . . . . . . . .CO2 . . . . . . .H2O . . . . . . . . . . . Other
g . MRI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . . . . . . . . . . . . . . . . . . . Other
h . Laboratory . . . . . . . . . . . . . . . . . . . . . . . . .ABC . . . . . . . . . . . . . . . . . . . . . . . Other
15 . Describe required operation of range hood fire extinguishing system: _____________
_______________________________________________________________________
_______________________________________________________________________
16 . Are 1½-inch hoses required on a standpipe system? . . . . . . . . . . . . . . . . . . . . . . Yes No
17 . Where are the standpipes and 2½-inch valves to be located? _____________________
_______________________________________________________________________
_______________________________________________________________________
19Health Facility Design Information Checklist
18 . What are the types and numbers of 2½-inch outlets required on the roof? __________
_______________________________________________________________________
_______________________________________________________________________
19 . Are backflow prevention devices required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
20 . Is a fire pump required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, does the fire pump have to be in a separate room? . . . . . . . . . . . . Yes No
b . If yes, what is the rating of room? ________________________________________
c . If yes, is it required to be directly accessible from outside? . . . . . . . . . . . Yes No
21 . Is the fire pump: Diesel Electric
22 . Is the fire pump sized by number of standpipes in that fire area? . . . . . . . . . . Yes No
23 . Should a redundant fire pump be provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
24 . How is fire pump to be fed electrically?
Directly from utility
On emergency power
Other requirements
25 . Are two connections to the public main required for a high rise? . . . . . . . . . Yes No
26 . How far is it from Siamese connection to the pumper hydrant? ___________________
27 . Is a second water supply required based on seismic zone? . . . . . . . . . . . . . . . . Yes No
28 . Is a post indicator valve (PIV) required outside? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is an outside screw & yolk (OS&Y) inside acceptable? . . . . . . . . . . . . . . . . Yes No
29 . What spacing is required for fire hydrants? ___________________________________
30 . Is a fire loop required around the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
31 . What is the mounting height for floor zone control valves? _______________________
32 . Is the building required to have a sprinkler head in every room/space? . . . Yes No
a . Are there any exceptions permitted per the building code? . . . . . . . . . . Yes No
b . If yes, explain: _______________________________________________________
33 . Are sprinkler heads required in portable wardrobes
(not part of building structure) that extend to ceiling or bulkhead? . . . . . . . Yes No
a . If not, what is the maximum depth/size wardrobe? _________________________
34 . What type of zoning is required for sprinkler system?
Zone per 52,000 ft
Zone per floor
Zone per smoke compartment
35 . Are fire sprinklers required outside under canopies? . . . . . . . . . . . . . . . . . . . . . Yes No
a . Over dock areas? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
36 . Is it permissible for the sprinkler drawings to be developed by
the sprinkler contractor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is a registered professional engineer seal required? . . . . . . . . . . . . . . . . . . Yes No
20 ASHE Monograph
37 . Can sprinkler heads be used in:
a . Electrical equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Elevator equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Computer/data processing rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Telecom equipment rooms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38 . Who will conduct capacity flow tests? ________________________________________
39 . Is smoke removal required for the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes: Natural Mechanical
40 . Is an engineered smoke control system required for the building? . . . . . . . . Yes No
41 . HVAC smoke control (non-high rise): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Air handling unit(s) in smoke compartment . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Entire building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Will shut down on activation of a:
i . Ceiling-mounted smoke/heat detector . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Detector in supply and return at Nurse Call (NC) unit . . . . . . . . . . . . . . . .
iii . Manual pull station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iv . A/S flow switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Smoke dampers will close via:
i . Interlock with nurse call (NC) system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Detector induct at damper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42 . HVAC Smoke Control (high-rise): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Discuss the smoke control system: _______________________________________
___________________________________________________________________
___________________________________________________________________
b . A/C unit(s) in smoke compartment in alarm will:
i . Shut down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Keep running . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Pressure relationship of smoke compartment in alarm relative to:
i . Adjacent smoke compartment: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos
ii . Floor above: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos
iii . Floor below: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Neg Pos
d . Smoke control system activates on initiation of:
i . Ceiling detectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Detectors at A/C unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii . Auto sprinklers in smoke compartment . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iv . Manual pull station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e . Ceiling detector at elevator? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
f . Will stair pressurization fans be required? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
21Health Facility Design Information Checklist
g . On alarm initiation of fire alarm system, the audio/visual alarms will sound:
i . On floor of incident and floor above and below . . . . . . . . . . . . . . . . . . . . .
ii . Throughout the building (general alarm) . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii . Smoke compartment of incident only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iv . Smoke compartment of incident and public spaces on floor
of incident, floor above and below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
v . Other ______________________________________________________________
43 . Communications
a . Will a fireman’s communication system be required?
(Some departments use radios only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If required, locate:
1 . Telephone handsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 . Telephone jacks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a . In stairwells at entrance to each level . . . . . . . . . . . . . . . . . . . . . .
b . In corridor at entrance to stairwell on each level . . . . . . . . . . .
c . Elevator lobbies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Fire pump rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e . Other ___________________________________________________
b . Other emergency communications required? ______________________________
44 . Is there an atrium? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, describe smoke evacuation system: _________________________________
___________________________________________________________________
b . Smoke evacuation of atrium is activated by:
i . Detectors in atrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Duct detectors in A/C system serving atrium . . . . . . . . . . . . . . . . . . . . . . .
iii . Automatic sprinklers in atrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iv . Beam detectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
v . Other __________________________________________________________
c . Can auto doors into atrium be used to introduce fresh air? . . . . . . . . . . . Yes No
d . What is the agreed on location to introduce fresh air, i .e ., what does
floor level mean? _____________________________________________________
45 . Are there anesthetizing locations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
46 . Are automatic sprinklers provided in the anesthetizing locations? . . . . . . . . Yes No
47 . HVAC systems serving anesthetizing locations shut down on:
a . Detector in anesthetizing location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Detector in A/C system serving anesthetizing location . . . . . . . . . . . . . . . . . . .
c . Detector in smoke compartment with anesthetizing location . . . . . . . . . . . .
d . Automatic sprinklers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22 ASHE Monograph
48 . Exhaust systems serving isolation room or fume hood locations shut down on:
a . Detector in location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Detector in A/C system serving location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Detector in smoke compartment with location . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Automatic sprinklers serving location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49 . Do stairways need compartmentalizing every few floors? . . . . . . . . . . . . . . . . Yes No
50 . Are automatic closers required on patient room corridor doors? . . . . . . . . . . Yes No
51 . Is a remote annunciator panel required on patient room corridor doors? . . Yes No
23Health Facility Design Information Checklist
PART 3: BUILDING SYSTEMS
Heating, Ventilation, and Air Conditioning Systems
*Per the officials listed, combination fire and smoke dampers are required where ducts penetrate:
BLDG OFFICIAL
FIRE OFFICIAL
DEPT OF HEALTH
4 hour wall (when allowed)
4 hour fire barrier
3 hour wall (when allowed)
3 hour fire barrier
2 hour fire wall
2 hour fire/smoke barrier
2 hour fire barrier
1 hour fire barrier
1 hour fire barrier (using sheet metal duct)
1 hour fire partition
1 hour fire/smoke barrier
Smoke partition
Smoke resistive wall
Floor penetrations
Penthouse floor
Roof penetrations
1 hour fire and smoke wall
Main electrical switchgear room (normal and EP)
Other
Other
24 ASHE Monograph
*Per the officials listed, fire dampers are required where ducts penetrate the following incidental room type (review fire barrier penetration with sheet metal duct exception when reviewing with authorities having jurisdiction):
BLDG OFFICIAL
FIRE OFFICIAL
DEPT OF HEALTH
Soiled workrooms
Soiled hold rooms
Clean workrooms
Clean supply rooms
Paint shops
Trash collection rooms
Repair shops
Storage rooms under 100 s .f .
Storage rooms over 100 s .f .
Gift shops
Kitchens
Boiler and heater rooms
Laundries
Locker rooms
Housekeeping closets
Film file (open storage)
Film file (closed storage)
Medical records
Business offices
Mechanical (fan) room walls
If unit only services one floor
If unit only services two floors
Electrical panel rooms
Elevator equipment room
Laboratories
Other
Other
25Health Facility Design Information Checklist
*Per the officials listed, smoke dampers are required where ducts penetrate:
BLDG OFFICIAL
FIRE OFFICIAL
DEPT OF HEALTH
2 hour fire wall
2 hour fire/smoke barrier
2 hour fire barrier
1 hour fire wall
1 hour fire/smoke wall
1 hour fire barrier
1 hour fire partition
Smoke partition
Smoke resistive wall
Floor
1 hour corridor wall
2 hour corridor wall
Horizontal exit
Other
Other
*Per the officials listed, smoke dampers are activated by:
BLDG OFFICIAL
FIRE OFFICIAL
DEPT OF HEALTH
Detectors 30’-0” o .c . in corridors
Detectors in Supply & Return ducts at A/C units
Detectors in smoke compartments
Detectors in duct near smoke dampers
Other
Other
*Note: Refer to Fire Prevention, Detection, and Protection Systems for control of HVAC systems during fire alarm Part 2: Facility Development .
26 ASHE Monograph
Per the officials listed:
BLDG OFFICIAL
FIRE OFFICIAL
DEPT OF HEALTH
It is permitted to undercut door for exhaust from:
Patient room to patient bath
Corridor to janitor closet or toilet
Maximum room size, if applicable
Smoke venting is required
Supply and return or exhaust is required in every room in building
There are local requirements regarding exhaust systems that cannot be combined into a common exhaust
Overflow condensate drain lines can be connected to the entering side of a sink tail piece with visible poly tubing or connected to a ceiling-mounted tell-tale drip above sink
The room-by-room air exchange rates and pressure relationships that are listed in the FGI Guidelines for the Design and Construction of Health Care Facilities are acceptable for minimum requirements
Several hazardous areas may be enclosed by a single 2 hour wall with fire dampers
Boilers are required to be in a separate room
Existing chillers and boilers located in the same room need to be separated
The occupied portion of the building can be located above a room with a boiler
A smoke proof tower is required
Separate smoke and fire damper assemblies are allowed where both are required at one wall face
27Health Facility Design Information Checklist
General Note: Refer to Fire Prevention, Detection, and Protection Systems for additional HVAC requirements for smoke evacuation, smoke control, and fire alarm interface in Part 2: Facility Development .
1 . What is the prevailing wind direction? _______________________________________
a . Are the cooling towers located downwind away from building
air intakes and entrances? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Are the air handling unit intakes located upwind of exhaust
air terminations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
2 . Prevailing wind affected by surrounding buildings or natural features? . . . Yes No
a . If yes, is a wind study provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
3 . For reliability and maintenance, what level of redundancy shall be provided for:
a . Chillers? ____________________________________________________________
b . Boilers? _____________________________________________________________
c . Air handling units? ___________________________________________________
d . Hazardous exhaust fans (hoods, aII)? ____________________________________
4 . Systems to be on emergency power:
a . Heating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Cooling (all or portion) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Heat recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Air handlers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e . Hazardous exhaust fans (AII, hoods) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f . General exhaust fans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 . Beyond the requirements of the Facility Guidelines Institute, are there spaces with
special user requirements for:
a . Temperature (central processing, NICU, etc)? . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, where? ____________________________________________________
b . Air changes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, where? ____________________________________________________
c . Exhaust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, where? ____________________________________________________
d . Humidity? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, where? ____________________________________________________
e . Filtration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, where? ____________________________________________________
6 . Are there any unique limitations relative to the size of the equipment due to access to
the site, building, etc .? ____________________________________________________
7 . Are there boilers with gas or diesel burners? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is an air quality operating permit required? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
28 ASHE Monograph
8 . Are the boilers provided with dual fuel burners? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
9 . Is on-site fuel oil storage provided for boilers? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, is fuel containment and monitoring system provided in:
Above-ground tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Underground tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 . Is combustion air provided for boilers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Freeze protection considerations for boiler room (sprinklers, etc)? . . . . Yes No
11 . Are chillers physically separated from fuel burning boilers and
water heaters? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
12 . Is refrigeration machinery room emergency ventilation required? . . . . . . . . Yes No
a . If yes, refrigerant monitoring system provided? . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Remote equipment emergency shut-off provided? . . . . . . . . . . . . . . . . . . Yes No
c . Remote ventilation control provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
13 . Air handler outside air intakes:
a . At least 6 feet above grade? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . At least 3 feet above roof? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . At least 25 feet from exhaust discharges, plumbing vents, and
medical vacuum system discharge? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
14 . Hazardous exhaust system discharge termination at least 10 feet
above roof? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
15 . Exit stairway(s) required to be pressurized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
16 . Horizontal exit passageway included in building? . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Ventilation system serving passageway is dedicated system? . . . . . . . . Yes No
17 . Elevator hoistway connects more than three floors? . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Hoistway pressurization provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . Elevator machine room conditioned and pressurized? . . . . . . . . . . . Yes No
b . Elevator lobbies provided with hoistway vent? . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Hoistway openings with provided with protection? . . . . . . . . . . . . . . . . . . Yes No
18 . Uninterrupible power supply (UPS) unit provided? . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Battery type and capacity require special ventilation? . . . . . . . . . . . . . . . . Yes No
19 . Are there pharmaceutical compounding spaces conforming to
USP 797? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Dedicated exhaust for chemo prep? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Air change rates for ISO classification? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Room pressure monitors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
20 . Are there pharmaceutical compounding spaces conforming to
USP 800? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
29Health Facility Design Information Checklist
21 . Are there emergency generators installed in a building? . . . . . . . . . . . . . . . . . Yes No
a . Exhaust silencer and discharge installed? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Fuel storage tank and pump with required capacity? . . . . . . . . . . . . . . . . Yes No
c . Double wall containment pipe and leak detection system? . . . . . . . . . . Yes No
d . Fuel conditioning system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
e . Fuel day tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
22 . Ventilation provided for enclosed and partially enclosed
parking garages? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Carbon monoxide and nitrogen dioxide detection system provided? Yes No
23 . Who reviews the plans for a building permit? __________________________________
24 . To whom must plans be submitted? _________________________________________
a . How many sets?______________________________________________________
25 . Plans should also be submitted to:
a . Electrical inspector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Plumbing inspector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Fire chief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Others _____________________________________________________________
26 . At what stage does the plan reviewer want to review drawings? __________________
_______________________________________________________________________
27 . Is action required back during design? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Is yes, what action? ___________________________________________________
b . Completed by (name)? ________________________________________________
c . Date completed by? __________________________________________________
30 ASHE Monograph
Plumbing Systems
Natural Gas
1 . Is gas available on a firm rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, maximum amount available? ______________________________________
2 . Is gas available on interruptible rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, maximum amount available _______________________________________
b . Duration of history of curtailment: ______days ______ months at one time to be off
3 . Required service to building: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other
a . Firm gas for lab, etc .? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other
b . Interruptible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other
c . Meter? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . One Two Other
4 . Approval to connect to gas for this project by: _________________________________
5 . Will there be a charge to bring gas to the site? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If so, what is the approximate cost? __________________________________________
6 . What pressure of gas is available? ___________________________________________
a . What is the minimum anticipated pressure? _______________________________
b . What is the maximum pressure acceptable to be routed through occupied space?
___________________________________________________________________
7 . Is a copy of the rate structure available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
8 . What is the BTU content of gas? _____________________________________________
9 . Who installs and pays for a high-pressure line? ________________________________
10 . Who sets the meter? ______________________________________________________
Is there a cost associated with this? __________________________________________
11 . Is a concrete pad or gravel required for meter? _________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
12 . Provide the required distance from meter to:
a . Building ____________________________________________________________
b . Louver _____________________________________________________________
c . Door _______________________________________________________________
d . Window ____________________________________________________________
e . Fuel tank ___________________________________________________________
Below ground ___________________________________________________
f . Oxygen park ________________________________________________________
g . Transformers ________________________________________________________
31Health Facility Design Information Checklist
13 . Is a seismic gas shutoff valve required on the gas main? . . . . . . . . . . . . . . . . . . Yes No
14 . Is a high-flow shutdown device required on the gas main? . . . . . . . . . . . . . . . Yes No
15 . Is a special pipe joint required for building settlement where gas line
enters the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
16 . Are natural gas building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Isometrics Flat
b . Full Partial
17 . What potential exists for negotiation of wellhead gas contract delivery? ____________
_______________________________________________________________________
18 . Is action required back during design? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Site plan locating building and gas meter? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Estimated gas demand in cubic ft/hr cubic ft/day ? . . . . . . . . . . . . . . . . . . Yes No
c . Application(s) required for providing new utility services to the
project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, describe: ___________________________________________________
d . Other ______________________________________________________________
19 . Completed by (name)? ____________________________________________________
20 . Date completed by? ______________________________________________________
32 ASHE Monograph
Domestic and Fire Water
1 . Location and size of the water main: _________________________________________
2 . Static pressure ____________ Residual pressure ____________ at ____________ GPM
3 . Total hardness in CaCo3 __________________ PPM/17 .1 = _________________ GPG
4 . Approval to connect this project to city water by: ______________________________
5 . Will there be a charge to bring water to this site? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
6 . Is it acceptable to have unmetered water on the property? . . . . . . . . . . . . . . . Yes No
a . City to own line? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Easement required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Size: _______________________________________________________________
c . May the meter be outside the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
7 . What is the water tap fee? _________________________________________________
8 . Is copy of area map on water available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
9 . Type and size of city water meter: ___________________________________________
10 . Is a special pipe joint required where the water line enters the building to allow for
building settlement, site settlement, etc .? ____________________________________
11 . City water entrance:
a . What is required?_____________________________________________________
b . Tapping sleeve & valve ________________________________________________
Who is responsible for this? ____________________________________________
Who pays? __________________________________________________________
City water meter:
a . Who pays for meter? __________________________________________________
b . Who sets meter? _____________________________________________________
c . Who pays to set meter? ________________________________________________
d . Can owner provide means to self-meter water usage? . . . . . . . . . . . . . . . Yes No
e . Who sizes the city water meter? _________________________________________
f . Location of water intake service backflow prevention device to be located:
Outside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g . Is redundancy provided for backflow prevention device? . . . . . . . . . . . . Yes No
h . Is reduced pressure backflow preventer required for backflow
prevention device? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . Are double check valve assemblies acceptable means of backflow prevention for
connections to ice machines and coffee makers? . . . . . . . . . . . . . . . . . . . . Yes No
j . Are air gaps on supply lines acceptable for connections to
ice machines and coffee makers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
33Health Facility Design Information Checklist
12 . Fire entrance — what is required? ___________________________________________
a . Meter ______________________________________________________________
b . Detector check ______________________________________________________
c . Reduced pressure backflow preventer (RPBP) ___________ of tapping sleeve
___________ and valve___________
d . Double check ________________________________________________________
e . Post indicator valve (PIV) ______________________________________________
f . Air gap (if on-site water tank) ___________________________________________
13 . What is required at connection to the city main? _______________________________
14 . Depth required for loop ___________________________________________________
15 . Type pipe required for loop ________________________________________________
16 . Pressure test required for loop ______________________________________________
17 . Can water not going to sewer be metered to avoid sewer charge? . . . . . . . . Yes No
18 . What are the fire line setbacks from structures or utilities? _______________________
19 . Are domestic water building riser diagrams required? . . . . . . . . . . . . . . . . . . . . Yes No
a . Isometrics Flat
b . Full Partial
20 . Are fire water building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Isometrics Flat
b . Full Partial
21 . If emergency fire water storage is required on-site:
a . What is the tank capacity required per NFPA? ______________________________
b . Are the tank openings (overflow pipe, tank vent) secured from
public access and provided with minimum 24-mesh? . . . . . . . . . . . . . . . . Yes No
c . Are hatches secured from public access? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
22 . If emergency domestic water storage is provided on-site:
a . Storage tank useable capacity provided __________________________________
b . Is there a provision to fill the tank via trucked-in water? . . . . . . . . . . . . . . Yes No
c . Are the tank openings (overflow pipe, tank vent) secured from
public access and provided with minimum 24-mesh? . . . . . . . . . . . . . . . . Yes No
d . Is the tank provided with AWWA-certified lining suitable for
potable water? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
e . Is there a provision to bypass tank for maintenance without
building service interruption? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
34 ASHE Monograph
23 . Confirm the following estimated quantity and quality of process is
adequate to meet landscaping needs without potable water use in
accordance with project agreements with municipality or LEED:
a . HVAC condensate: ____________________________________________________
b . Reverse osmosis (RO) system rejected water: ______________________________
c . Rainwater: __________________________________________________________
d . Other: ______________________________________________________________
24 . Confirm with municipality amount of annual rainfall expected to be
diverted to rainwater capture system: ________________________________________
25 . Is action required back to city? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Site plan showing entry to the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Approximate meter location? __________________________________________
c . Estimated water demand 6 pm __________________ GPD ___________________
d . Estimated fire water use 6 pm ___________________ GPD ___________________
e . Application(s) required for providing new utility services to
the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, describe: ___________________________________________________
f . Other ______________________________________________________________
26 . Completed by (name)? ____________________________________________________
27 . Date completed by? ______________________________________________________
35Health Facility Design Information Checklist
Plumbing Fixtures
1 . Food service plumbing (confirm with health department):
a . Is floor is required to slope toward drain? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Is floor required to be flat, regardless of area drain location? . . . . . . . . . Yes No
c . Is exposed piping required to be chrome-plated for cleaning? . . . . . . . Yes No
d . Are floor sinks for indirect waste piping required to be:
i . Flush with floor?
ii . Raised rim?
e . Is documentation required to illustrate adequate capacity and
temperature for domestic hot water to kitchens? . . . . . . . . . . . . . . . . . . . . Yes No
f . Natural gas loads for kitchen equipment submitted to utility? . . . . . . . Yes No
2 . Plumbing fixtures:
a . Are non-aerating flow controls provided on faucets? . . . . . . . . . . . . . . . . Yes No
b . Do fixture flow rates comply with AHJ requirements? . . . . . . . . . . . . . . . Yes No
c . Hazardous chemical handling areas:
i . Are sinks provided with a countertop berm or other protection
to prevent chemical spills from entering the sewer system? . . . . . Yes No
ii . Are emergency eyewashes and/or showers provided within
10 seconds travel time for staff handling hazardous chemicals? . . Yes No
3 . Completed by (name)? ____________________________________________________
4 . Date completed by? ______________________________________________________
36 ASHE Monograph
Sanitary Sewer
1 . Location, size, and invert elevation of sewer ___________________________________
2 . Is approval needed to connect this project to city sewer system? . . . . . . . . . Yes No
a . If yes, is approval needed for where to connect? . . . . . . . . . . . . . . . . . . . . . Yes No
b . Who needs to provide approval? ________________________________________
3 . Is a special pipe joint required where the sewer lines exit the building
to allow for building settlement, site settlement, etc? . . . . . . . . . . . . . . . . . . . . Yes No
4 . Will there be a charge to bring sewer to site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
5 . What is the sewer tap fee? _________________________________________________
6 . Is a copy of the area map on sewers available? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
7 . Is a comminutor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If yes, where? ____________________________________________________________
8 . What is the minimum size of connection to the city sewer? ______________________
9 . Is a lift station required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
10 . Is a grease interceptor located: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inside Outside
a . Is a grease trap required at dumpster? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Any sizing criteria for grease trap? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Sampling well required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
11 . Are oil/water interceptors required for hydraulic elevator pit drainage? . . . Yes No
a . Is it acceptable to provide oil minder controls on sump pump
in lieu of oil/water interceptor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Discharge piping to sanitary or storm? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Discharge piping through exterior wall at grade? . . . . . . . . . . . . . . . . . . . Yes No
12 . Drainage discharge from traction elevator pit routed? . . . . . . . . . . . . . . . . . . . Yes No
a . Sanitary Storm
b . Discharge piped through exterior wall at grade? . . . . . . . . . . . . . . . . . . . . Yes No
13 . Minimum slope ___________ Maximum slope _________ of outside/inside sewer pipe
14 . Type pipe: (outside)
a . Cast iron: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . PVC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Clay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
d . Concrete: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
15 . May the following drain into the sanitary sewer?
a . Dishwasher—140°: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Boiler blowdown: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Drain at dumpster: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
16 . Is there a city standard for manholes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
17 . Are profiles required for sewer on the property? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
18 . Maximum distance between 8-inch sewer pipe manholes _______________________
37Health Facility Design Information Checklist
19 . Does the AHJ allow ”plastic” type (Orion for instance) for acid waste,
reverse osmosis water, deionized water, etc ., and does it have
to be fire wrapped? _______________________________________________________
20 . What are the requirements for decontamination tank at ER, such as
size and construction of tank? ______________________________________________
21 . Does the AHJ allow connection of decontamination tank drain or
overflow drain to municipal sewer system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
22 . Fuel oil storage restrictions:
a . Can PVC/DWV schedule 40 pipe be used:
i . For waste and vent pipe inside the building? . . . . . . . . . . . . . . . . . . . . Yes No
If acceptable, will piping be required to be fire wrapped? . . . Yes No
ii . Above ceiling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
iii . Below slab? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . What are the requirements for drainage from helidecks and
containment of fire extinguishing foam? . . . . . . . . . . . . . . . . . . . . . . Storm Sanitary
c . What are requirements for drainage of transformer vaults? . . . . .Storm Sanitary
23 . Define floor drain requirements for “staff” and “public” restrooms . _________________
_______________________________________________________________________
24 . May fire protection test water be sent to sanitary sewer? . . . . . . . . . . . . . . . . . Yes No
25 . Has municipality approved fire test flow rates/volumes for
sanitary sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
26 . Are sanitary sewer building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . Yes No
a . Isometric Flat
b . Full Partial
27 . What are requirements for drainage or parking structures?
a . Storm Sanitary
b . Oil/water interceptor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . Size criteria? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
28 . Is action required back to city? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Site plan locating building and point sewer leaves property? . . . . . . . . . Yes No
b . Invert elevations of sewer at property line? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Estimated sewer load gallons per day (GPD) _______________________________
d . Application(s) required for providing new utility services to
the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, describe: ___________________________________________________
e . Other ______________________________________________________________
29 . Completed by (name)? ____________________________________________________
30 . Date completed by? ______________________________________________________
38 ASHE Monograph
Storm Drainage
1 . Location, size, and invert elevation of storm drain: ______________________________
2 . Is approval needed to connect this project to city storm system? . . . . . . . . . Yes No
a . If yes, is approval needed for where to connect? . . . . . . . . . . . . . . . . . . . . . Yes No
b . Who needs to provide approval? ________________________________________
3 . Is a special pipe joint required where the sewer lines exit the building
to allow for building settlement, site settlement, etc? . . . . . . . . . . . . . . . . . . . . Yes No
4 . Does AHJ require filtration of storm water prior to discharging to
drainage system? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
5 . Will there be a charge to bring storm drainage to site? . . . . . . . . . . . . . . . . . . . Yes No
6 . What is the drainage tap fee? _______________________________________________
7 . Is a copy of the area map on storm utility available? . . . . . . . . . . . . . . . . . . . . . . Yes No
8 . What is the minimum size of connection to the city storm system? ________________
9 . Is a lift station required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
10 . May HVAC condensate drainage be routed to storm drain? . . . . . . . . . . . . . . . Yes No
11 . May fire protection test water be sent to storm drain? . . . . . . . . . . . . . . . . . . . . Yes No
12 . Has municipality approved fire test flow rates/volumes for storm drain? . . . Yes No
13 . Minimum slope _____________ Maximum slope _____________ of outside storm pipe
14 . Type pipe: (outside)
a . Cast iron: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . PVC: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Clay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
d . Concrete: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
15 . Is there a city standard for manholes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
16 . Are profiles required for drainage on the property? . . . . . . . . . . . . . . . . . . . . . . Yes No
17 . What is the maximum distance between 8-inch drainage pipe manholes? __________
_______________________________________________________________________
18 . Storm pipe restrictions:
a . Can PVC/DWV schedule 40 pipe be used:
i . For storm piping inside the building? . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
ii . Above ceiling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
iii . Below slab? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
iv . Storm? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
v . Sanitary? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
19 . What are requirements for drainage of transformer vaults? . . . . . . . Storm Sanitary
20 . Are storm building riser diagrams required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Isometrics Flat
b . Full Partial
21 . Detention sizing _________________________________________________________
39Health Facility Design Information Checklist
22 . Water quality treatment sizing ______________________________________________
23 . Impacts to site development _______________________________________________
24 . What are the required site capacities vs . allowable capacity? _____________________
25 . What are the cooling tower blowdown and makeup water metering requirements?
_______________________________________________________________________
26 . What are the requirements for drainage of parking structures? ___________________
_______________________________________________________________________
a . Storm Sanitary
b . Oil/water interceptor required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . Provide size criteria . _______________________________________________
27 . Is it acceptable to pipe overflow roof drainage system to bubbler basins
on grade in lieu of piping through exterior wall to discharge
above grade? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Will bubbler basins require secondary means of drainage? . . . . . . . . . . . Yes No
28 . Is action required back to city? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Site plan locating building and point drainage leaves property? . . . . . . Yes No
b . Invert elevations of drainage at property line? . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . Application(s) required for providing new utility services to the
project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If yes, describe: ___________________________________________________
d . Other ______________________________________________________________
29 . Completed by (name)? ____________________________________________________
30 . Date completed by? ______________________________________________________
40 ASHE Monograph
Bulk Medical Gases
1 . Confirm minimum clearances from medical oxygen bulk storage to:
a . Non-ambulatory patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b . Sewer inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c . Property lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d . Stored fuel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e . Schools and places of public assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f . Nearest opening in wall or other structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g . Parked vehicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
h . Other: ______________________________________________________________
2 . Is truck access to medical gas bulk storage acceptable to supplier? . . . . . . . Yes No
3 . Is emergency oxygen supply connection provided to exterior of building
accessible to supply vehicles? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
4 . Are emergency reserves provided for each medical gas system? . . . . . . . . . . Yes No
5 . Is medical vacuum producer separate from waste anesthesia gas disposal
source (WAGD)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
6 . Is the medical vacuum producer also serving WAGD sized and
constructed of materials suitable for both systems? . . . . . . . . . . . . . . . . . . . . . . Yes No
7 . Completed by (name)? ____________________________________________________
8 . Date completed by? ______________________________________________________
41Health Facility Design Information Checklist
Electrical
1 . Are two feeds available from separate substations to the site? . . . . . . . . . . . . Yes No
2 . If yes, is an automatic transfer available or manual only? _________________________
a . What is the estimated cost? ____________________________________________
3 . What is the power company’s reclose scheme? ________________________________
4 . Will there be a charge to bring power to the site? . . . . . . . . . . . . . . . . . . . . . . . . Yes No
5 . Is a primary service available from the utility of the property?
(for campus-style developments) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
6 . Is the utility service from the substation routed overhead or underground?
_______________________________________________________________________
7 . Is service from a vault acceptable? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Dry vault (above ground) or wet vault (below grade)? _______________________
b . Who furnishes? (If owner, obtain power company’s vault standard
and specifications) ___________________________________________________
8 . Is service through a pad-mounted transformer acceptable? . . . . . . . . . . . . . . Yes No
9 . Who furnishes the pad-mounted transformer? _________________________________
10 . If service is through a pad-mounted transformer, does the power
company limit the maximum number of secondary conduits? . . . . . . . . . . . . Yes No
11 . Does the power company have standard maximum available transformer
sizes they stock and will they furnish? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what sizes are available? __________________________________________
b . Is 480/277 volt service available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
i . If no, what voltage is available? _____________________________________
12 . Who pours the pad for the transformer? ______________________________________
(If it is the owner, obtain the power company’s standard pad detail .)
13 . Are there any clearance restrictions (from walls, doors, and so forth) on locating the
transformer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what are they? __________________________________________________
14 . Is conduit necessary for primary conductors? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, who furnishes? _________________________________________________
(If owner furnishes primary conduit, obtain power company’s standard detail
for underground conduit .)
b . Are spare conduits required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
15 . Who furnishes and installs the primary conductors? ____________________________
(If owner, obtain power company’s specifications .)
Who installs and terminates these conductors? ________________________________
16 . Who furnishes the secondary conductors? ____________________________________
Who installs and terminates these conductors? ________________________________
42 ASHE Monograph
17 . Does the power company limit the maximum conductors per phase on the secondary?
_______________________________________________________________________
18 . Who furnishes the metering? _______________________________________________
19 . Is a primary metered service available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . Where is the meter to be located? _______________________________________
b . Is any metering conduit required? _______________________________________
c . Is telephone line required at the meter? __________________________________
20 . In the case of multi-tenant buildings, is it permissible to meter each
tenant separately? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
21 . Does the utility require hot or cold sequence metering?
(hot sequence indicates the meter before any disconnecting means,
cold sequence has a disconnect prior to the meter) . . . . . . . . . . . . . . . . . . . . . . Yes No
22 . Can a copy of applicable rate schedules be obtained? . . . . . . . . . . . . . . . . . . . . Yes No
a . What type of load sharing programs are available for the owner’s consideration?
___________________________________________________________________
b . Does the generator have to be tier I? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
c . What is the proposed cost paybacks of such a program? _____________________
23 . Who is the phone company/internet provider/satellite/cable incumbent
local exchange carrier (ILEC) in this area? _____________________________________
24 . What action is required back to the power company site plan showing
building and transformer location? __________________________________________
a . Estimated connected or added load _____________________________________
b . Firms requesting service _______________________________________________
25 . Are any easements or right-of-way legal documents needed to bring
the new service to the project site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
26 . Is the site subject to flooding (refer to Part 2 — Facility Development —
Site Considerations)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, then locate switchgear and emergency generation equipment
above flood plain .
27 . Define the sequence of operation with respect to the emergency generator
power system . ___________________________________________________________
28 . Are closed transition transfer switches permitted (closed transition switches
synchronize and parallel the standby generator[s] with the electric system for
approximately 100 milliseconds when transferring)? ____________________________
29 . What are the minimum hours of emergency generator run time without refueling?
_______________________________________________________________________
30 . Is emergency electrical distribution equipment required to be in
a separate room? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
43Health Facility Design Information Checklist
31 . Are diversified electrical loads accepted for:
a . Emergency generator _________________________________________________
b . Wiring, panels, etc . ___________________________________________________
32 . Is UPS required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, what equipment is connected to it? ________________________________
33 . Besides loads mandated by codes to be connected to an emergency
generator system (alternate power source), what optional loads need to be
picked up by the generator system? _________________________________________
34 . Is the emergency generator system to provide full back-up power
to the facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
35 . What is the maximum sound level permitted for emergency generator? ____________
36 . What EPA emission tier requirements must the generator meet? __________________
a . If there are multiple emergency generators are they to be
paralleled? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
b . Is N+1 required for the emergency generator system? . . . . . . . . . . . . . . . Yes No
37 . Is electrical switchboard required to be in a separate room? . . . . . . . . . . . . . . Yes No
38 . Fire pump:
a . How is electricity supplied to pump?
i . Served directly from utility transformer ahead of main breaker
for building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii . Served from main switchboard ahead of main breaker . . . . . . . . . . . . . .
b . Is the fire pump required to be on emergency power? . . . . . . . . . . . . . . . Yes No
c . What special requirements are not in the latest addition
of the NEC 695? ______________________________________________________
Questions for electrical plan reviewer/inspector:
1 . Is plan review required for electrical permit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, who conducts the reviews? _______________________________________
2 . Do any special codes apply (energy codes and so forth)? . . . . . . . . . . . . . . . . . Yes No
a . If yes, what are they? __________________________________________________
3 . Are there local requirements on outside lighting levels, shielding, heights,
and so forth? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
a . If yes, please explain further . ___________________________________________
4 . Is natural gas a suitable source for dual fuel source emergency generator
system in this jurisdiction? _________________________________________________
5 . Will overcurrent protection coordination studies be allowed as a deferred
submittal after contractor and equipment selection? ___________________________
6 . Does the EPA air permit need to be revised or updated? _________________________
7 . What equipment needs to be connected to emergency power? ___________________
8 . What equipment needs to be on UPS? _______________________________________
44 ASHE Monograph
PART 4: APPENDIX
Sustainability
1. Generala. Applicable energy code (CalGreen, ASHRAE 90.1, IECC, etc.)b. Applicable green code (CalGreen, ASHRAE 189.1, etc.)c. Advanced Energy Design Guide (AEDG)
2. Architecturala. Space program
i. Locate staff offices and breakrooms on exterior walls for access to daylight and views
ii. Allocate and locate separate spaces for areas of respite and connection to nature for(1) Staff(2) Inpatients(3) Visitors
b. Windowsi. Prescriptive maximum allowable window-to-wall ratioii. Prescriptive maximum window assembly thermal parameters (U
value and solar heat gain coefficient)c. Opaque envelope
i. Roof(1) High solar reflective index (cool roof ) to minimize heat island
effects and rooftop operating temperatures for roof mounted HVAC equipment and outside air intakes
(2) Prescriptive maximum U value of roof assemblies(3) Evaluate use of green roof for both storm water abatement
(trade-off for artificial site impoundment or detention) and energy use and peak HVAC load reduction
ii. Walls(1) Prescriptive maximum U value of wall assemblies (including
spandrel panels)
45Health Facility Design Information Checklist
iii. Floors(1) Prescriptive maximum U value of floor assemblies (both slab
on grade as well as floors exposed to semi-conditioned and unconditioned space)
iv. Commissioning(1) Consider envelope commissioning in compliance with
ASHRAE Guideline 0–2005 and the National Institute of Building Sciences (NIBS) Guideline 3–2012
v. Materials (1) Avoid use of materials with
(a) Volatile organic compounds (VOCs) including added formaldehydes
(b) Persistent, bioaccumulative, and toxic chemicals(2) Preferential use of materials
(a) Rapidly renewable or carbon sequestering(b) Post-consumer recycled content(c) Closed cycle reusable and recyclable(d) Low embodied energy(e) Locally sourced or manufactured (LEED v.4 is within 100
miles)(f ) Environmental Product Declaration®(g) Material transparency
3. Mechanicala. General. Avoid oversizing equipment. Provide for additional capacity
and redundancy through the use of multiples of parallel or staged equipment trains
b. Refrigerants. Avoid the use ozone depleting and global warming potential refrigerants
c. Minimize the use of reheat throughi. Variable air volume control where allowed, including unoccupied
setbacksii. Expanded temperature control range and deadbands, including
unoccupied setbackiii. Resetting supply air and water temperatures at part loadiv. Heat recoveryv. Decoupling heating/cooling from ventilation through the use of
heat recovery chillers or heat pumpsvi. Consider using natural and mixed-mode ventilation for non-
clinical spaces where appropriate based on climate and program
46 ASHE Monograph
d. Provide separate process paths for the control of i. Ventilation air and humidity ii. Sensible space temperature
e. Use variable frequency drives on fan and pump motors 1 hp and largeri. For energy consumption report and record to the building
automation system variable frequency drive kWhf. For air delivery systems that operate more than 8,000 hours annually,
size coil rows and face velocities and filter banks so that the sum of all systems fans’ (supply, return, and exhaust) motor nameplate power does not exceed 0.0009 kW/system supply CFM
g. Select cooling tower approach and range to minimize fan sizeh. Use separate cooling loops for low temperature applications so that
central plant water temperatures are not lowered to meet these applications’ needsi. Avoid the use of air-cooled refrigeration equipment that rejects
heat into conditioned spaces. Use either remote air-cooled condensers or water-cooled equipment
j. Use displacement ventilation for high ceiling and multiple-story spacesk. HVAC Controls
i. Use supply air temperature (SAT) reset for variable air volume systems
ii. Use static pressure reset for supply fans on variable air volume systems
iii. Include chilled water temperature reset controls iv. System metering for energy consumption: Install permanent
water flow meters that report and record to the building automation system flow rates and associated MBH for applicable building systems including steam, steam condensate, chilled water supply, process chilled water supply, condenser water flow, heat recovery water supply, and hydronic heating water supply.
4. Plumbinga. Use site recovered water for cooling tower makeupb. Use cooling tower water makeup systems and treatment that
maximize cycles of concentrationc. Avoid the use of potable water for cooling in any non-emergency
application (sterilizer and washer drains, MRI, lab, ice machines, etc.). Use closed loop cooling systems.
d. Reuse laundry rinse water for applicable and appropriate non-potable use
47Health Facility Design Information Checklist
e. For water metering, where practical install permanent water meters that report and record to the building automation system for irrigation, cooling tower makeup, domestic hot water makeup, boiler makeup, pools and therapy suites, purified water systems, closed loop hydronic system makeup, and/or dietary department
f. Use low-flow fixturesg. Use rainwater collection where possible for non-potable useh. Use EPA WaterSense® labeled products for toilets, urinals, private
lavatory faucets, and shower heads5. Electrical
a. Poweri. Use high efficiency transformersii. Meter electrical energy consumption and report to the building
automation system for the following(1) Indoor lighting(2) Exterior lighting(3) Vertical transportation systems(4) HVAC equipment(5) Medical and vacuum equipment(6) Data and IT (MDF and IDF) rooms
iii. Consider continuous monitoring and commissioning systems b. Lighting
i. Provide occupancy or timed control of lighting to either shut off or reduce to 10 percent of lighting energy consumption when spaces are unoccupied
ii. Provide daylight harvesting in non-clinical daylight spacesiii. Minimize lighting power density to no more than 75 percent of
the maximum allowed by codeiv. Minimize exterior lighting trespassv. Use LED lighting where possiblevi. Provide lighting controls for individually occupied spaces
(1) 5.2.6.1. Staff(2) 5.2.6.2. Inpatient
48 ASHE Monograph
Technology
1. Service Entrancea. Identify the closest point of presence for the telecommunications
service providersb. Identify the location on the site for the telecommunication services
connection pointsc. Who provides the conduits to the connection points? d. What are the service providers’ requirements for service entrance
conduits and the entrance facility room demarcation point?e. Are there at least two telecommunication service entrances to the
building, separated by 20 feet?f. Are conduits for future buildings coordinated with the site plan and
entrance facility rooms?g. Determine the bandwidth needed to support the facilityh. Determine the number of analog lines needed to support the facilityi. Include services for data, voice, and television
2. Structured Cabling Systema. Backbone cabling to support minimum of 10 GbE (gigabite Ethernet)b. Horizontal cabling to support minimum of 1 GbE; 10 GbE is preferredc. Elevator phones connections providedd. Telecommunication rooms per NFPA-99 and FGI Guidelinese. Grounding and bonding providedf. Is low-voltage wiring above ceiling required to be in conduit?
3. End User Devicesa. Staff computers—account for PCs with dual monitorsb. Staff phones—VOIP or digitalc. Patient room phones—VOIP or digitald. Red emergency phone locations e. Multifunction devices (copy, scan, fax, email); coordinate with
architectural design for space to include clearances for service and maintenance
f. Specialty printers; provide connections and space for label printers, flatbed scanners, and other ancillary devices
49Health Facility Design Information Checklist
4. Data Centersa. Server requirements to determine number of cabinets, power,
and coolingb. Storage requirements to determine number of cabinets, power,
and cooling
c. Cooling systems: Plan for N+1 redundancy, connect to emergency power
d. Power systems: Plan for N+1 redundancy, maintenance bypass, emergency power
e. Fire protection systems: Fire protection fluid systems (non-water)f. Evaluate cold aisle containment systems for feasibilityg. Growth: plan for 100 percent growth of data center space per
TIA-1179 (Healthcare Facility Telecommunications Infrastructure Standard) by planning soft space next to data center. Plan for growth in mechanical and electrical systems
5. Wireless Systemsa. Determine wireless access point devicesb. Determine if the wireless system is for data only or for voice
communicationsc. Provide (2) CAT6A cables per wireless access pointd. Provide a wireless heat map survey using an industry accepted
simulation/modeling software
6. Distributed Antenna System (DAS)a. Will the DAS be for public safety systems only or for cellular carriers?b. Provide additional space for DAS equipment
7. Special Systemsa. Real time locating services: determine the location technology to be
used (RFID, ultrasound, and wireless) b. Wireless clinical communications requires robust wireless systemc. Patient entertainment/education
i. Integrate with EMR?ii. Integrate with dietary?iii. Educational content? By whom?iv. Movie subscription provided? v. Integrate with hospital apps?
50 ASHE Monograph
d. Telemedicine: determine technology and locationse. Registration: biometric scanners, label printers, kiosks, mobile
registration cartsf. Time in attendance: coordinate locationsg. Alarm management middleware for integration of nurse call, EMR,
lab, pharmacy, RTLS systems (real time located services)h. Dictation i. Synchronized clocks: determine locations and type of clocks
(GPS, network)
8. Security Systemsa. Access control
i. Identify access control credential technology (smart card, proximity)ii. Identify locations for access control doorsiii. Coordinate access control wiring and devices with door
hardware designiv. Coordinate power, fire alarm interfaces, and life safety provisions
(delayed egress)v. Special considerations:
(1) Labor and delivery(2) Psychiatric(3) Pediatrics(4) Emergency lockdown sequences (active shooter,
decontamination, etc.)(5) High rise stairwell access(6) Automatic doors
vi. Provide a credentialing station with camera and backdropvii. Coordinate server requirements with IT
b. CCTVi. Identify locations for CCTV cameras ii. Determine the proper pixels per foot for the desired level of
recognitioniii. Determine the field of view of each cameraiv. Coordinate with the reflected ceiling planv. Special considerations
(1) License plate recognition(2) Low light conditions(3) Motion activation
vi. Determine the required number of days of video storage
51Health Facility Design Information Checklist
vii. Determine monitoring locationsviii. Coordinate network storage and server requirements with ITix. Coordinate site camera locations with landscaping plansx. Determine requirements for integration with other systems
(1) Access control system(2) Duress alarm system(3) Smartphone apps
c. Intercomi. Determine locations and desired functionii. Network-based intercom allows flexibilityiii. Can function be achieved through VOIP phone system?
d. Duressi. Emergency department, nurses stationsii. Integrate with security systems
9. Paging Systemsa. Design to limit noise pollution in patient areasb. Is a separate building-wide paging system required for emergency
announcements?
10. Television Systemsa. Listed for health care useb. Coordinate blocking c. Specify mount with TVd. Coordinate control with nurse call or other patient devices
11. Audio Visual Systemsa. Paging b. Background musicc. OR integrationd. Surgical suite intercom
12. Emergency Radio Systemsa. Determine which frequencies are required to be supported b. Coordinate antenna locationsc. Coordinate structural supports for antennasd. Provide weatherproof penetrations for antenna cablese. Determine radio station locations (emergency department, incident
command center, security)
52 ASHE Monograph
Additional Information and Notes
Below are codes and standards referenced in this checklist that may also be useful to the user:
FGI Guidelines for Design and Construction of Health Care Facilitieswww.fgiguidelines.org
Green Building Councilwww.usgbc.org
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
53Health Facility Design Information Checklist
www.ashe.org